Video ethnography for quality improvement
Watching patient/provider interactions in realtime can make it easier to see the process from the patient perspective and spot opportunities for improvement. In healthcare interactions, as in just about any people-oriented service, issues that are obvious when seen in context can get lost when an interaction is described by bare data. In an era where structured data is so important, it can be very useful to step back and look for a richer picture of the service you are providing, without a preconception of what is going to be significant.
I was interested to read about Kaiser Permanente’s use of video ethnography to observe patients as they receive care in order to gain insight into unmet patient needs and overlooked issues. From an article on collaborations between insurers and providers to use data owned by the insurer to improve population health:
California-based Kaiser Permanente is using video ethnography to identify and address gaps in communication and care. The approach builds on the fields of anthropology and social science, but adds modern technological components such as video and data analytics to tackle vexing problems such as high readmission rates for senior citizens with heart failure. By studying videotaped interactions between patients and caregivers, Kaiser soon had a clearer picture of why some heart patients were returning to the hospital so quickly. In many instances, confusing medication instructions or a lack of access to nutritious food were the culprits– painfully obvious on the videos. After revamping their processes, 30-day readmission rates at one medical center fell from 13.6 percent to 9 percent in six months. —Source: Advancing healthcare informatics: insurers lead the way
The resulting video clips from this type of project can help identify gaps and opportunities, explain discrepancies between what people say and do, and highlight unexpressed patient needs – needs that they may not even recognize themselves.
One problem noted in Kaiser’s Toolkit is that “the compelling nature of video ethnography can create a risk that your organization may want to chase after anecdotes and act immediately in response to individual patient stories.” It can also be very difficult for stakeholders to set aside personal views and listen to some of the more problematic situations described by interviewees.